Preinjury Social Determinants of Health Disparities Predict Postinjury Psychosocial Conditions in Adult Traumatic Brachial Plexus Injuries.

Autor:	Maasarani S; Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA., DeLeonibus A; Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA., Wee C; Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA., Leavitt T; Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA., Lee CD; Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA., Khalid SI; Department of Surgery, Rush University Medical Center, Chicago, Illinois, USA., Layon S; University of Minnesota School of Medicine, Minneapolis, Minnesato, USA., Gharb BB; Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA., Rampazzo A; Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA., Noland SS; Division of Plastic and Reconstructive Surgery, Department of Surgery, Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Jazyk:	angličtina
Zdroj:	Neurosurgery [Neurosurgery] 2023 Jul 01; Vol. 93 (1), pp. 215-223. Date of Electronic Publication: 2023 Feb 20.
DOI:	10.1227/neu.0000000000002406
Abstrakt:	Background: Adult traumatic brachial plexus injuries (TBPIs) are life-altering events that can have detrimental effects on a patient's quality of life. Objective: To examine how social determinants of health (SDOH) disparities influence the risk of developing new psychosocial conditions after TBPIs in previously psychiatric-naïve patients. Methods: Between January 2010 and June 2019, a retrospective analysis was performed using PearlDiver's Mariner, an all-payer claims database, to create 3 cohorts: TBPI disparity cohort: patients with TBPI and presence of at least 1 SDOH disparity before injury, TBPI without disparity cohort: patients with TBPI and the absence of any SDOH disparity, and control cohort: patients without TBPIs. Results: The matched population analyzed in this study consisted of 1176 patients who were equally represented in the TBPI disparity cohort (n = 392, 33.33%), TBPI without disparity cohort (n = 392, 33.33%), and control cohort (n = 392, 33.33%). A total of 301 patients developed any psychosocial condition with 4 years of their injury. Patients in the TBPI disparity cohort had significantly higher rates of developing any psychosocial condition (31.12%, P < .0005), depression (22.70%, P = .0032), anxiety (18.62%, P = .0203), drug abuse (7.91%, P = .0060), and alcohol abuse (4.85%, P = .03499) when compared with the other cohorts. Furthermore, the disparity cohort carried a significantly increased risk of developing any psychosocial condition (hazard ratio 1.42, 95% CI 1.09-1.86). The rates of suicide attempt, post-traumatic stress disorder, and divorce did not significantly differ between groups. Conclusion: TBPI patients with SDOH disparities are at increased risk of developing new-onset psychosocial conditions, such as depression, anxiety, drug abuse, and alcohol abuse. Level of Evidence: Prognostic Level III. (Copyright © Congress of Neurological Surgeons 2023. All rights reserved.)
Databáze:	MEDLINE
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